fusion T12 - L5

After having tried numerous pain meds, MRIs, ESIs, bone density scan, and a myelogram, I got a call from the surgeon's nurse saying he was recommending a fusion from T12 - L5. This is due primarily because of scoliosis and stenosis. I'm already fused from L5 - S1. I've also had 2 laminectomies in the lumbar region. I go for a consultation on the 28th.

I'd like to hear from those of you who have had fusions at extensive levels. What can I expect in terms of hospital stay, need for care after I come home (since I'm on Medicare, I'm guessing I'll go somewhere for rehab - how long?), flexibility, etc. Also, what are some questions I should ask when I go for the consultation?

I was expecting surgery, but not anything of this magnitude. My one - level fusion was 7 years ago, and the other surgeries after that.

The following user gives a hug of support to carken:
Pepperpot1808 (12-20-2010)

After you go see this surgeon, I would strongly suggest you get opinions from at least one more spinal surgeon. Be sure you are going to a fellowship-trained spine specialist -- either an orthopedic spine surgeon or a neurosurgeon who devotes his practice to issues of the neck and back. I'm a BIG believer in getting a number of opinions from surgeons in different practices, and even different cities, if there tends to be one hospital or university where the majority of doctors have trained.

Any time you get over two levels, the difficult increases and the chances for a complete fusion go down, so it is really important to find a doctor who has lots of experience doing multi-level surgeries. You want to be absolutely sure in your own mind that you will be receiving the correct surgery for your situation.

My neurosurgeon meets all the requirements you set forth and is head of neurosurgery at two hospitals. He only does surgeries on the neck and back. A friend had fusions from T3 - S1 about 15 years ago. She was seeing this doctor and he sent her to a surgeon in another city, so I'm confident that if he doesn't feel adequate to do the surgery he will do the same for me. He has performed 3 prior back surgeries for me, each for different problems and they have all been successful.

Excellent! Sounds like you are in good hands, and more important, that the procedure he is recommending is appropriate for your issues.

The questions you asked in your post would be a good place to start with the doctor. Also, I would want to know what type of surgery he is proposing, how will he access the spine, front, back, both? What type of hardware will be involved? What type of limitations will you have after the surgery?

I would also want to know if there are any alternatives to having so many levels fused. What would be the results of NOT fusing this many levels.

I don't know anyone that has had that many levels fused, so I'm afraid I cannot comment further. I wish you the best as you make your decision.

I had a T10-L3 fusion added on to my previous L3-S1 fusion last February, so now have 8 levels/9 vertebrae fused. I was in the hospital 3 days I think and went home with few restrictions. I had to have it redone in March due to hardware failure and the hospital stay was about the same. These were my 8th and 9th surgeries on my spine (5 on my lower back and 4 on my neck), so it was nothing new to me. I've never been one to coddle myself and I didn't this time either. Was it painful? Yes, but manageable. Did I have restrictions? Yes, mostly due to the "clamshell" I was fitted with pior to the surgery. I was in that for 10 weeks. Do I have current limitations? Yes, much less flexibility in my lower back of course. I struggle putting on socks and cannot reach most of my toes, so I have to get a pedicure to clip my nails. I wasn't alone after the surgery, but even if I was I don't see where I would have had too many problems.

My current problems are due to the interaction of this last fusion with the surgeries I've had in my neck (C4-C7 fusion, C3/C4/C5 laminaplasty & C6/C7/C8 foraminotomies). My neck, back of my head and upper shoulders now are very painful if I sit and work at a computer for more than 1 hour. This makes working impossible, as my job entailed sitting and working at a computer for 10-12 hours a day. I also have pain in my lower back when sitting for that length of time or standing for more than 15 minutes. The reason for my surgeries is a degenerative spine, not scoliosis, so your result may be entirely different. I've heard that most scoliosis patients with long fusions do quite well, so I'm hoping you have the same result.

Good luck with everything. I know it's scary thinking about the surgery, but it'll be over before you know it and you can get back to your life.

I was in to see the PM doctor today for refills, and when I told him the surgeon's recommendations, he suggested maybe a spinal cord stimulator implant. I will discuss this with the surgeon to see if it might be an option. I just don't know how long it would be effective.

I'm 69 and in excellent health except for my back, but I'd hate to need the surgery in a few years and not be a candidate because of some health problems that might arise. Decisions, decisions!

I think you're right. It seems like some doctors automatically suggest a spinal chord stimulator when the situation seems more complicated than they care to deal with -- at least that was my experience. You're trying to protect the structural integrity of your spine rather than just trying to ease the pain somewhat, so the SCS wouldn't be all that helpful going down the road....

I'm the "former carken" of T12 - L5. Due to some insurmountable password problems, I've had to totally change my identity. Crazy! Now I'm carolaann. Anyway, I appreciate your comments and will discuss all this with my surgeon on the 28th.

Hi Carol,
Sorry to hear about the situation you are in but try not to get too stressed and take it one step at a time. You have been given some great advice here, theres so many caring people here!
My situation is kinda like yours but opposite regarding the order of the surgeries. I had scoliosis surgery first from L4 to T5. I was only 15 then (48 now) and I can honestly tell you the surgery was not to bad. And it was done very different then,alot of progress has been made in the procedures and results with scoliosis surgery are much better. Back then I was in a plaster cast from my hips to my chin for 9 months.....no more of that nowadays! But like I siad,it wasint to bad.
My second surgery was in 2008,posterior fusion w/hardware from S1 toL4. All levels fused good except the L3 L4 level and thats was only becouse of the prior fusion working as a lever. You wont have this issue I had revision done this past May which was anterior/posterior with hardware to secure L4 L3 agian.....Now its the wait and see thing Anyway thats my history about multi level fusions, now thats out of the way! lol
I think you have a very good surgion from what you have siad and since your possible new fusion will be above the old one it should be better but I would still discuss this with your Dr. and another thing I would ask is if he would have to remove hardware from your prior fusion to "incorporate" the two together. Sometimes old hardware can be in the way. My Dr siad he hoped he wouldint have to do this but the old hardware was in the way and needed to be removed. I hope I am not being to blunt but its a question that needs to be asked as it does effect recovery time.
As far as recovery, I would assume that you would benefit from a rehab post surgery,I was in the hosp. for 6 days and rehab for 7 days...it was very benificial to get the rehab before I went home.
Well thats my story, ask your Doc those questions. Get all the info you can.